281 - Incidence of Tumor Seeding Following Adnexal Mass Biopsies, Aspiration And/or Drain Placement

Purpose: This study aims to investigate the incidence of tumor seeding following biopsy, aspiration or drain placement in females with adnexal masses. The findings could impact clinical practice by contributing to the development of guidelines outlining when biopsy or drain placement is appropriate in patients. Further expanding upon the true risk of these procedures will help to establish safer interventional procedures and improve patient care and outcomes in the treatment of adnexal masses.

Materials and Methods: This retrospective cohort study reviewed all females who underwent gynecologic biopsy, aspiration, or drain placement from 2007-2024 at a single institution’s interventional radiology department. Data collected from the patient’s chart included demographics, clinical history, procedure details, and outcomes including cancer progression or tract seeding found on imaging within one year of procedure, as well as procedure-related complications within 30 days. Descriptive statistics, Fisher’s exact, and Wilcoxon rank sum exact tests were run to determine differences in patient- and procedure-related characteristics between those with and without disease progression.

Results: A total of 27 patients were included, with a mean age of 58.1 years. Seventeen (63.0%) had biopsies, 7 (25.9%) aspirations, and 3 (11.1%) drain placements. Of the lesions biopsied, 13 (81.2%) were malignant (one biopsy was categorized as neither malignant nor benign), and 9 (69.2%) of the malignant lesions were confirmed to be of ovarian origin. No patients had tumor seeding within one year of the procedure nor any procedure-related complications within 30 days. Eleven (40.7%) patients experienced disease progression within one year. No statistical significance was found between the presence of disease progression and patient medical history, menopausal status, procedure type or imaging modality used.

Conclusion: Due to the nature of interventional procedures used when performing a biopsy, aspiration, or drain placement in the setting of suspicious or confirmed malignancy, physicians must consider the potential risk of tumor seeding through spread of the lesion’s material. In this study, no patients experienced tumor seeding or complications. There was also no difference in patient- and procedure-related characteristics between those who experienced disease progression and those who did not.